International journal of dentistry · 2026
Challenges and Solutions in Delivering Preventive Periodontal Care to Older Adults in Community and Long-Term Residential Care Settings: A Scoping Review.
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Chakraborty Ankita, G Deepa Kamath, Shenoy Nina, Basu Anwesha, Sinha Aradhya
Аннотация
BACKGROUND: Preventive periodontal care is essential for older people in the community to reduce the risk of tooth loss, systemic diseases, and decreased quality of life. Despite its importance, older people in assisted living, home-based care (HBC), daycare, and other community settings face barriers to effective preventive periodontal care, including mobility, cognitive, and caregiver knowledge issues. Although these challenges are being recognized more and more, the evidence on barriers and solutions for delivering consistent preventive periodontal care remains scattered across different study designs and care contexts.
AIM AND OBJECTIVE: The aim of this scoping review is to map the existing literature and systematically identify the key challenges at patient, caregiver, and institutional levels, along with evidence-based solutions-including behavior change techniques (BCTs), tools, and interventions-for delivering preventive periodontal care to older adults in community and mixed residential settings.
METHODS: The Joanna Briggs Institute scoping review method, along with the PRISMA-ScR, was followed to identify the key issues, solutions, and findings related to the implementation of preventive periodontal care in older people in the community. The inclusion criteria were older people aged 60 years or more, interventions, community, or mixed settings, and the languages were restricted to English. The search was conducted for articles from 2010 or later. Two-phase selection was used, which yielded 32 articles. This was followed by data extraction, including study design, settings, population, interventions, outcomes, issues, solutions, thematic synthesis, etc.
RESULTS: Thirty-two studies were included (12 cross-sectional, 8 RCTs/quasi-RCTs, 6 systematic reviews/protocols, and 6 others). Included studies were conducted mainly in nursing homes (n = 15), with 10 in community and 7 in mixed settings. Key challenges were identified at the resident, caregiver, and institutional/systemic levels. Resident-level challenges included cognitive and functional limitations, while caregiver-level barriers included gaps in knowledge and the relatively low priority given to oral care. At the institutional and systemic levels, workload, limited access to professional dental care, and the lack of standardized oral-care protocols were frequently reported. Solutions included carer education with BCTs, standardized tools (e.g., Oral Health Assessment Tool [OHAT]), visual aids, AI-supported screening, regular professional outreach brushing, and interprofessional models, showing modest short-term improvements in plaque index (PI), gingival index (GI), and bleeding on probing (BOP).
CONCLUSIONS: Persistent challenges underscore the need for integrated, accessible strategies to enhance preventive care. Future research should prioritize cost-effectiveness, community-focused RCTs, and long-term evaluations to improve oral health outcomes in aging populations.
AIM AND OBJECTIVE: The aim of this scoping review is to map the existing literature and systematically identify the key challenges at patient, caregiver, and institutional levels, along with evidence-based solutions-including behavior change techniques (BCTs), tools, and interventions-for delivering preventive periodontal care to older adults in community and mixed residential settings.
METHODS: The Joanna Briggs Institute scoping review method, along with the PRISMA-ScR, was followed to identify the key issues, solutions, and findings related to the implementation of preventive periodontal care in older people in the community. The inclusion criteria were older people aged 60 years or more, interventions, community, or mixed settings, and the languages were restricted to English. The search was conducted for articles from 2010 or later. Two-phase selection was used, which yielded 32 articles. This was followed by data extraction, including study design, settings, population, interventions, outcomes, issues, solutions, thematic synthesis, etc.
RESULTS: Thirty-two studies were included (12 cross-sectional, 8 RCTs/quasi-RCTs, 6 systematic reviews/protocols, and 6 others). Included studies were conducted mainly in nursing homes (n = 15), with 10 in community and 7 in mixed settings. Key challenges were identified at the resident, caregiver, and institutional/systemic levels. Resident-level challenges included cognitive and functional limitations, while caregiver-level barriers included gaps in knowledge and the relatively low priority given to oral care. At the institutional and systemic levels, workload, limited access to professional dental care, and the lack of standardized oral-care protocols were frequently reported. Solutions included carer education with BCTs, standardized tools (e.g., Oral Health Assessment Tool [OHAT]), visual aids, AI-supported screening, regular professional outreach brushing, and interprofessional models, showing modest short-term improvements in plaque index (PI), gingival index (GI), and bleeding on probing (BOP).
CONCLUSIONS: Persistent challenges underscore the need for integrated, accessible strategies to enhance preventive care. Future research should prioritize cost-effectiveness, community-focused RCTs, and long-term evaluations to improve oral health outcomes in aging populations.